The present invention relates generally to orthopedic devices such as braces, and more particularly to a traction device which is specifically adapted to restore the head, neck and thoracic""s normal postural alignment by the application of dual anterior and posterior adjustable external forces.
As is well known in the medical field, a significant portion of the population suffers from a protruded or forward head posture. It has been found that chronic postural head placement forward or anterior to what is medically deemed to be physiologically neutral contributes to a wide range of adverse medical conditions, including thoracic outlet syndrome, temporomandibular joint dysfunction syndrome, dysfunctional closing pattern of the mandible, pain due to stretched muscles, adaptive muscle shortening, dorsal scapular nerve entrapment, and headaches.
The human spine consists of first through seventh cervical vertebrae, with the first cervical vertebrae being attached to the base of the scull or occiput. After the seventh cervical vertebrae, the spine transitions into the first through twelfth thoracic vertebrae, with the first thoracic vertebrae being adjacent the seventh cervical vertebrae. The thoracic vertebrae in turn transition into the first through fifth lumbar vertebrae. It has been determined that xe2x80x9cforward head posturexe2x80x9d is attributable to the lower cervical vertebrae being flexed in forward glide, and the upper cervical complex being extended. Stated another way, forward head posture causes the upper cervical complex to be held in a position of extension, with the lower cervical vertebrae being misaligned and often fixated in a position of flexion. This condition often occurs as a result of injury or chronic head-down or head-forward activities.
Medical study of forward head posture has revealed the effects of positive and negative Z-axis cervical translational positions upon the patient""s symptoms. More particularly, it has been found that the head retraction motion, or negative Z-axis translation, causes the lower cervical vertebrae or segments to move toward an extended position, while the upper cervical vertebrae or segments become more flexed. This finding that pulling the head into a posterior translation causes flexion or kyphosis of the upper three or four cervical vertebrae has lead to the conclusion in the medical field that the head retraction motion constitutes a mirror image traction for the correction of forward head posture.
In an effort to correct forward head posture as well as misaligned lateral cervical curvatures, there has been developed in the prior art various forms of cervical extension traction which, in some cases, involve some degree of negative Z-axis translation (i.e., head retraction). However, all of these known forms of extension traction subject the upper cervical vertebrae or segments to a negative X-axis rotational force (i.e., head extension). As a result, the performance of these procedures on patients with upper cervical extension fixations does not result in optimal correction of forward head posture.
The present invention provides a wearable collar for a patient which is specifically configured to apply Z-axis translational traction to the cervical spine of the patient which, as indicated above, is a unique force related to head retraction motion that has been proven to reduce forward head posture and decrease neck pain. The present collar effectively draws the patients head into a posterior translation or head retracted posture, and then applies a secondary anterior traction into the mid-cervical vertebrae in order to restore the normal lordosis through the process of viscoelastic creep. In this respect, the Z-axis translational traction causes the sixth and seventh cervical vertebrae and first thoracic vertebrae to be stretched into extension, while the spinal region encompassing the occiput and first and second cervical vertebrae is simultaneously stretched into flexion. In addition to being able to restore the normal lordosis to the cervical spine and reduce forward head posture, the present invention is able to traction and relax the rectus capitis posterior minor muscle which has been proven to have a connective tissue link to the spinal dura matter and is widely considered a major cause of cervicogenic headaches.
Though there is also known in the prior art various cervical braces and traction devices, such prior art braces and traction devices are generally intended to support and immobilize the head and neck of a patient after injury, and not to restore the head, neck and thoracic""s normal postural alignment by the application of dual anterior and posterior adjustable external forces. In this respect, though some of these prior art braces and traction devices provide either a posterior Z-axis translational force to the skull, an adjustable axial or vertical Y-axis superior directed traction to the cervical spine, or an adjustable compressive inferior directed force to the cervical spine, none of these prior art braces or traction devices provide an adjustable anterior Z-axis translational force to the mid-cervical region of the spine for purposes of remodeling the normal postural alignment and rehabilitating the normal cervical spinal lordosis. These, and other advantages associated with the present invention, will be discussed in more detail below.
In accordance with the present invention, there is provided a collar which is wearable by a patient or user for reducing forward posture of the user""s head by restoring normal forward lordosis or forward curvature to the user""s cervical vertebrae. The present collar is configured to be positionable over the user""s head and neck, and upon the user""s shoulders and chest. In the preferred embodiment, the collar comprises a main frame including a pair of side bars having upper portions which extend in spaced, generally parallel relation to each other and lower portions. In addition to the side bars, the main frame comprises an arcuately contoured top bar which is attached to and extends between (i.e.,interconnects) the upper portions of the side bars. The arcuate configuration of the top bar causes the same to extend posteriorly about or behind the user""s head when the collar is worn by the user.
The upper portions of the side bars and the top bar collectively define a top section of the main frame which is positionable over the user""s head and neck. The lower portions of the side bars define a bottom section of the main frame which is positionable upon the user""s chest and shoulders. In the preferred embodiment, the upper portion of each of the side bars of the main frame comprises a pair of telescoping sleeves which allows the lengths of the upper portions to be selectively increased or decreased. In this respect, the main frame further preferably comprises a locking mechanism which is cooperatively engaged to the upper portions of the side bars and operative to maintain the upper portions at prescribed lengths. The locking mechanism may comprise spring tabs which are cooperatively engaged to each of the upper portions.
In addition to the main frame, the present collar comprises a posterior traction member which is attached to the main frame, and more particularly the top section thereof. The posterior traction member is operative to apply a posteriorly directed force (i.e., a negative or posterior Z-axis translational force) to the user""s head or skull which draws the head into a posterior translation or head retracted posture. The posterior traction member itself preferably comprises an elongate, flexible strap or belt having opposed ends which are attached to respective ones of the upper portions of the side bars included in the top section of the main frame. The strap itself defines an inner surface which is engagable to the user""s head and includes a layer of a padded material such as neoprene disposed thereon. In addition to the inner surface, the strap defines an outer surface which has a layer of hook and loop fastener material or Velcro disposed thereon.
In addition to the posterior traction member, the present collar comprises an anterior traction member which is also attached to the top section of the main frame and operative to apply an anteriorly directed force (i.e., a positive or anterior Z-axis translational force) into the user""s cervical vertebrae. This anteriorly directed force acts in concert or cooperation with the posteriorly directed force to cause certain cervical vertebrae to be stretched into extension while other cervical vertebrae are simultaneously stretched into flexion. The anterior traction member preferably comprises a flexible or rigid cervical sling member which is engagable to the back of the user""s neck and movably attached to the upper portions of the side bars of the main frame. In addition to the cervical sling member, the anterior traction member comprises an adjustment mechanism which is cooperatively engaged to the cervical sling member and operative to selectively move the cervical sling member toward and away from the upper portions of the side bars, and hence the user""s neck.
The cervical sling member is preferably attached to the upper portions of the side bars via a pair of externally threaded bolts, with the adjustment mechanism preferably comprising a pair of control knobs which are threadably engaged to respective ones of the bolts and positioned on the anterior side of the top section of the main frame. The rotation of the control knobs in a first direction facilitates the movement of the cervical sling member toward the upper portions of the side bars, with the rotation of the control knobs in a second direction opposite the first direction facilitating the movement of the cervical sling member away from the upper portions of the side bars. The cervical sling member is preferably covered with a layer of padding material for enhancing its comfort when engaged to the user""s neck. This padding material may comprise a temperature controllable elasto-gel or other material. Additionally, it is contemplated that the cervical sling member may be provided with an inflatable air bladder which is selectively inflated via a hand-held inflator bulb.
In the present collar, the adjustability of the posterior and anterior traction members allows the posteriorly and anteriorly directed forces applied to the user thereby to be selectively set to a desired level. Additionally, the adjustability in the lengths of the upper portions of the side bars of the top section of the main frame, in cooperation with the locking mechanism, allows the posterior traction member to be maintained at a prescribed height from the anterior traction member as is needed to suit the proportions of a particular user.
Further in accordance with the present invention, there is provided a method of reducing forward head posture and restoring normal lordosis or forward curvature to a patient""s cervical vertebrae through the use of the above-described collar which is wearable by the patient. The method comprises the initial step of placing the main frame of the collar upon the patient""s shoulders and chest such that the anterior traction member is positioned behind the patient""s neck. Thereafter, the posterior traction member is tightened across the patient""s head until a posteriorly directed force of a prescribed level is applied thereto. More particularly, the tightening of the posterior traction member is preferably continued until such time as the patient""s head is drawn back to a position whereat the openings of the patient""s ears are located above the patient""s shoulders. Finally, the anterior traction member is tightened until an anteriorly directed force of a prescribed level is directed into the back of the patient""s neck. Subsequent to the tightening of the anterior traction member, the collar is preferably worn, on a repetitive basis, by the patient for anywhere from five to thirty minutes, depending on the patient""s physical tolerance.